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Pettitte was lucky that the fracture was at the fibula and not along the inside ankle bone, the tibia. This is because the fibula is a non-weight bearing bone as compared to the tibia, which is the larger of the two lower leg bones. As long as the fibula fracture is not displaced, surgery is usually not necessary and in most cases, the patient only needs to be in a walking boot.
Besides a direct blow to the fibula, other causes of this fracture are landing from a jump, or spraining the ankle. Fibula fractures are common in sports that require a quick change of direction such as, football, soccer and basketball.
If one sprains their ankle, or lands funny after a jump, a fibula fracture must be ruled out. The patient will usually limp or be unable to put any weight on the associated foot. We have seen severe displaced fractures of the fibula, where the bone is protruding out of the skin. Obviously, in this case, the fracture has to be repaired surgically. X-rays are used to diagnose this fracture and in some cases, an MRI or CT scan might be required.
For a non-displaced fibula fracture, such as the one Pettitte has, treatment usually is walking with a protective boot and/or the use of crutches for six weeks. The fracture is evaluated periodically to assess healing via radiographs. Once healing has occurred, the patient has physical therapy to get the ankle moving.
The patient must avoid all strenuous activities that might put a strain on the fibula. If the patient ignores the pain, the fracture can worsen, and then might require surgical correction. If the fracture is treated properly and quickly, the patient will heal to a full recovery and will be able to resume all activities within a couple of months.
It is most likely that Pettitte will not pitch until September, since it takes about 6 weeks for the bone to heal and then he will need a couple of weeks of therapy as well as time to strengthen his arm again.
